The following article is sponsored by University of Utah Health Care.
By Natalie Dicou
It seemed like just a harmless sugar cookie. But a few bites in, Debby DeBoer felt the piercing abdominal pain that she’d been experiencing on and off since the beginning of 2015, and this time it wasn’t going away.
DeBoer has a high pain tolerance, but this was on another level.
“You can’t sit, and you can’t sleep because you can’t lie down,” said DeBoer, who lives in Clearfield. “I just walked and paced around my house.”
She thought the pain, which typically reared its head after eating, was related to her carcinoid cancer, a slow-growing cancer that began in her small intestine. But, in the emergency room, doctors told her it wasn’t her cancer after all.
Turns out, DeBoer had a diseased gallbladder from gallstones. Could it be that easy? Could one of the most common surgeries — gallbladder removal or cholecystectomy — really end the excruciating episodes?
A nonessential organ
“The liver is always making bile, and bile is important because it helps you digest fat and protein and absorb certain vitamins. When you’re not eating, you don’t need all that bile in the intestine because there’s nothing for it to do, so the gallbladder is a little storage organ that contracts and empties bile into the intestines when you eat.”
Sounds pretty important, doesn’t it? Well, not so much: Between meals, the gallbladder only stores 10-20% or about a cup of bile, and the rest is already in the intestine.
“It is interesting that as humans have evolved to be more like grazers who eat frequently, the importance of the gallbladder in our ability to digest our food has diminished tremendously,” Glasgow said. “So, for example, if you only ate one large meal a day or every few days, like a snake, presumably the gallbladder has more relevance.”
Gallbladder gone wrong
With her gallbladder identified as the likely culprit, DeBoer’s doctor in Davis County searched for a surgeon. Because of DeBoer’s rare carcinoid cancer, undergoing general anesthesia, which is necessary to remove the gallbladder, was potentially very dangerous. Glasgow, who’s known for performing complicated intestinal operations and is familiar with carcinoid tumors in his role as a surgeon at Huntsman Cancer Institute, stepped in.
Once inside, he found one of the worst gallstone diseases he’s ever seen.
“These were his words: It was really, really, really, really, really, really bad,” DeBoer remembered.
Gallstones are hard masses made up of a mixture of cholesterol, calcium and other bile components that can cause episodic pain in the right upper abdomen that lasts several minutes to several hours and often strikes after eating fattening or high-protein foods, Glasgow explained.
Women, especially those who have had children and those in their premenopausal 40s, are more likely to get gallstones than men. After menopause age, the occurrence of gallstones evens out between the sexes. Those with a strong family history of gallstones, overweight people and individuals who are losing weight rapidly are also susceptible to gallstones, which can be as tiny as a grain of sand and can grow as large as a golf ball. While gallstones are common, most are harmless. In fact, 75% of patients with gallstones have no pain or other symptoms. It’s only when the stones cause pain that gallbladder removal surgery should be considered, Glasgow said.
The surgery has come a long way since President Lyndon Johnson famously showed photographers the 12-inch scar that stretched across his belly. Glasgow says that today more than 95% of patients who need their gallbladders removed can have it done laparoscopically through four small incisions, each as big as a fingernail.
A few agonizing days after DeBoer ate the fateful sugar cookie, she emerged from surgery sans the small sac that used to live below her liver.
“You don’t even know. I could just cry,” DeBoer said, trying to find words to describe her relief. “Right away, I couldn’t feel the horrible pain anymore. I feel like a new woman. I’m 100% better.”
Although DeBoer’s cancer can’t be cured, it’s stable and treatable, and Glasgow assured her she can lead a long and happy life. A week after surgery, she’s enjoying eating again, and was looking forward to chicken roll-ups, which her daughter was bringing over.
“Thank heavens Dr. Glasgow stepped in and did the surgery,” she said. “I think he’s one in a million.”
Not a silver bullet
Because gallbladder problems are very common and removing the gallbladder is relatively easy to do, many people with abdominal pain and/or other abdominal symptoms like nausea, diarrhea and upset stomach think it can help them too. Sometimes an ultrasound will reveal that a patient’s gallbladder is abnormal, but after Glasgow discusses the pain with the patient, it’ll be clear that, despite the abnormality, the pain isn’t coming from the gallbladder.
“The gallbladder gets blamed for a lot of things,” Glasgow said. “That’s a difficult conversation that we have several times a week.”
Glasgow cautions that even though it’s a straightforward surgery, there can still be rare but significant complications from the surgery, and it’s vital that the gallbladder be truly implicated before it gets the boot.
“If you’re born with it, and it ain’t botherin’ ya, keep it,” Glasgow says.
In DeBoer’s case, it was definitely bothering her. Looking back, she thinks she let it go too far.
“Just get it checked if you have pain,” DeBoer advises. “If it keeps up, there’s something wrong. Let them think you’re crazy.”
Do you think your gallbladder might be causing your abdominal pain? Click here or call 801-585-1618.